That's an old wives' tale. It's only barely based on facts, but rather a twisting of them. Yes, Heritage pushed for a similar system, but a. not this one at all (there's far more differences than similarities), and b. they didn't originally propose it, as it predated their proposal by many years.
And my goodness. You think the exchanges are competition
?? You cannot be serious. You are required
to be a part of the exchange, as a seller or consumer of insurance. You are required
to be a consumer of insurance. Most insurance features are mandated, and there's a cap on the services provided. There's price controls on the cost of the insurance.
Every objective observer has said that the ACA will result in a homogenization of health insurance options, both in that the law requires them to be more similar in nearly every important way, and in that smaller insurers -- due to the lack of ability to compete on services and costs, due to the mandates -- will simply go away. You will have less
choice and less
competition due to this manufactured and mandated "market."What does price transparency create? Competition.
As I already pointed out, that's only true if the people who are making the choices are the ones impacted by the prices, which is not the case today.
Yes, businesses choose insurers for their employees based on prices, but consumers usually do not make any
choices based on price, no matter how transparent the prices are, because the consumers don't pay that price (or, they don't pay it directly).
No, price transparency in health care can only work to create competition needed to drive down costs if the consumers of care are directly responsible for the costs. That's why some insurers are going to high-deductible HSA plans -- to get the consumers more involved in price-based choice -- but this is only a partial solution.Price increases are slowing, have been since this bill was passed, have been in Massachusetts since Romneycare.
But they are still increasing unsustainably, whereas a free market would make prices actually decrease.The most important point of both bills is maintenance. If you do regular maintenance on your car, it runs better, costs less, doesn't break. Same thing applies to you.
And I get to choose whether to purchase maintenance for my car, and how to pay for it (as soon as I am done writing this, I am leaving to get my tires rotated, and that's not a euphemism!). You're just emphasizing the fact that you're a statist who doesn't believe in freedom, rather than making a serious case for why the bill is reasonable.Mandating care, getting everyone into the pool, provides incentives -- MARKET incentives -- for accountable care organizations to do that regular maintenance on you, and so reduce costs.
First, I don't buy it as a theory. I've heard it before, and I've read the studies, and I understand the theory. But I was taking my pills before the bill passed; now that they are free (on the basis that if they are free, I'll be more likely to take them, thus saving money), it doesn't provide any
such cost savings. Maybe there's people out there who aren't taking these (inexpensive) pills because they cost money, and will now that they don't, but the impact on overall costs will likely be small.
I am not saying preventative maintenance doesn't save costs. I am saying that there is no strong evidence that these mandates will result in a significant increase in preventative maintenance such that costs will actually be saved.
Second: those incentives to reduce costs exist almost completely apart from the ACA! You really think a company needs a government incentive to lower its costs? Come on. The ACA did very little to change the incentive structure. We did see some changes, like allowing outcome-based models, but that itself is far from a clear positive, and could be a net negative for health care outcomes. My daughter went for years with an undiagnosed condition, and the doctors did a lot of work on her, and it's easy to see how they would have been de-incentivized
to work on her at all, in an outcome-based model, where there is little chance of success from the outset.
(Indeed, we did see some doctors essentially give up on her because they couldn't figure out what to do next. If their compensation is more directly based on outcome, that becomes a far more common occurrence.)
Finally, this -- at best -- pales in comparison to the cost savings provided by the free market when consumers are making price-based choices. The free market "magically" (it seems like magic, but it's simple human behavior) gets us lower prices, increased quality, and broader availability.
It really does.